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NPI Code Detail

MEDICARE: KAMDEN GRAY

MEDICARE: KAMDEN GRAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1871433797
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMDEN GRAY
Provider Business Mailing Address
First Line : 526 SHRADER ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94117-2714
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1411 E 31ST ST
Second Line :
City : OAKLAND
State : CA
Zip : 94602-1018
Country : US
Telephone Number : 818-599-4824
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2026
Last Update Date : 03/31/2026

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Directions to “ KAMDEN GRAY ” Practice Location

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